Better technology can bring better care -- and higher costs

A new study examines whether innovations in health care technology are too much of a good thing.

By Susan J. Landers, AMNews staff. Dec. 15, 2003.

Washington -- Carolyn Clancy, MD, director of the Agency for Healthcare Research and Quality, remembers when there was only one CT scanner in Worcester, Mass., where she received her medical training. When patients needed scans they were transported to the CT site via ambulance.

Flash forward 20 years, and CT scanners are now where the patients are. Nearly 80% of hospitals have their own CT equipment, and more than 50% have their own MRI scanners, according to the American Hospital Assn.

This is good news for physicians and patients. CT and MRI scans were selected as the most valuable of medical innovations in a 2001 survey of primary care physicians.

But it also could be too much of a good thing. It has long been known that the costly scanners, as well as the many other technological advances -- such as those that help tiny babies survive and allow diabetic patients to better monitor their blood sugar levels -- are driving up health care costs.

A study in the November/December Health Affairs examined the relationship between the increasing availability of technology and health care spending and found that "if you build it, they will come," said lead author Laurence Baker, PhD, an associate professor of health research and policy at Stanford University School of Medicine.

However, in studying diagnostic imaging, cardiac care, cancer care and newborn care, the researchers found that not all technologies resulted in the same patterns of use.